Burnout syndrome, anxiety, depression and reproductive cycle in informal caregivers of cancer patients
PDF (Español)

Keywords

Burnout syndrome
Anxiety
Depression
Informal caregivers
Reproductive cycle Síndrome de burnout
Ansiedad
Depresión
Cuidadoras informales
Ciclo reproductivo

Abstract

Background. The activities of informal caregivers are highly demanding, stressful, and are generally associated with emotional overload leading to negative effects on health. This is relevant since burnout syndrome manifests itself when people cannot adaptively face stressful situations when they feel impeded to modify them. Such responsibilities are frequently carried out by women whose gonadal hormonal changes affect her mood. Objective. To determine if the stage of their reproductive cycle has an impact on the likelihood of developing burnout syndrome, anxiety, and depression symptoms. Also to determine if there is a hormonal protective effect that might be helping informal caregivers cope with the demands of their work. Method. The sample consisted of 37 informal caregivers of cancer patients evaluated for Burnout syndrome, anxiety, and depression symptoms. For a more specific analysis, participants currently reproductive were compared to postmenopausal caregivers. Results. Moderate positive correlations emerged among these dimensions not implying a cause-effect relationship. No burnout syndrome, anxiety, or depression resulted in the group of postmenopausal caregivers, but they also reported greater family support. Discussion. Results suggest that the absence of plasma fluctuations in gonadal hormones (postmenopausal) and higher perceived emotional support protect against burnout.

https://doi.org/10.25009/pys.v32i2.2753
PDF (Español)

References

Akpan-Idiok, P.A. y Anarado, A.N. (2014). Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria. The Pan African Medical Journal, 18, 159. Doi: 10.11604/pamj.2014.18.159.2995.

Asberg, M., Nygren, A., Leopardi, R., Rylander, G., Peterson, U., Wilczek, L., Källmén, H., Ekstedt, M., Akerstedt, T., Lekander, M. y Ekman, R. (2009). Novel biochemical markers of psychosocial stress in women. PloS One, 4(1), 3590. Doi: 10.1371/journal.pone.0003590.

Avendaño, C., Bustos, P., Espinoza, P., García, F. y Pierart, T. (2009). Burnout y apoyo social en personal del servicio de psiquiatría de un hospital público. Ciencia y Enfermería, 15(2), 55-68. Doi: 10.4067/S0717-95532009000200007.

Beck, A.T. y Steer, R.A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: Psychological Corporation.

Buck, K., Williamson, M., Ogbeide, S. y Norberg, B. (2019). Family physician burnout and resilience: a cross-sectional analysis. Family Medicine, 51(8), 657-663. Doi: 10.22454/FamMed.2019.424025.

Calderón N., G. (1997). Un cuestionario para simplificar el diagnóstico del síndrome depresivo. Revista de Neuro-Psiquiatría, 60(2), 127-135. Doi: 10.20453/rnp.v60i2.1406.

Centers for Disease Control and Prevention and the Kimberly-Clark Corporation (2008). Assuring healthy caregivers, a public health approach to translating research into practice: the RE-AIM framework. Atlanta, GA: Centers for Disease Control and Prevention.

Cerquera C, A.M., y Pabón P., D.K. (2016). Resiliencia y variables asociadas en cuidadores informales de pacientes con Alzheimer. Revista Colombiana de Psicología, 25(1), 33-46. Doi: 10.15446/rcp.v25n1.44558.

Choi, K.W., Stein, M.B., Dunn, E.C., Koenen, K.C. y Smoller, J.W. (2019). Genomics and psychological resilience: a research agenda. Molecular Psychiatry, 24(12), 1770-1778. Doi: 10.1038/s41380-019-0457-6.

Contreras, C.M., Azamar A., G., Saavedra, M. y Hernández L., M. (2006). A five-day gradual reduction regimen of chlormadinone reduces premenstrual anxiety and depression: a pilot study. Archives of Medical Research, 37(7), 907-913. Doi: 10.1016/j.arcmed.2006.05.001.

Contreras, C.M. y Gutiérrez G., A.G. (2017). Progesterone modifies the responsivity of the amygdala-mPFC connection in male but not female Wistar rats. Neuroscience Letters, 649, 1-6. Doi: 10.1016/j.neulet.2017.04.002.

Contreras, C.M. y Gutiérrez G., A.G. (2020). Estrogen and progesterone priming induces lordosis in female rats by reversing the inhibitory influence of the infralimbic cortex on neuronal activity of the lateral septal nucleus. Neuroscience Letters, 732, 135079. Doi: 10.1016/j.neulet.2020.135079.

Contreras, C.M., Gutiérrez G., A.G., Bernal, B., Rodríguez J., F. y Muñoz L., D. (2008). Changes in lateral septal nucleus neuron firing rate and coping with forced swim during gestation in the Wistar rat. Animal Behaviour, 76(4), 1219-1225.

Contreras, C.M., Molina, M., Saavedra, M. y Martínez, L. (2000). Lateral septal neuronal firing rate increases during proestrus-estrus in the rat. Physiology & Behavior, 68(3), 279-284. Doi: 10.1016/s0031-9384(99)00169-9.

Converso, D., Viotti, S., Sottimano, I., Loera, B., Molinengo, G. y Guidetti, G. (2019). The relationship between menopausal symptoms and burnout. A cross-sectional study among nurses. BMC Women's Health, 19(1), 148. Doi: 10.1186/s12905-019-0847-6.

Cooper, A.L., Brown, J.A., Rees, C.S. y Leslie, G.D. (2020). Nurse resilience: a concept analysis. International Journal of Mental Health Nursing, 29(4), 553-575. Doi: 10.1111/inm.12721.

Cortijo P., X., Bernal M., B., Gutiérrez G., A.G., Díaz D., E., Hernández B., D. y Cibrián Ll., I.T. (2018). Psychological-affective evaluation of advanced cancer patients and caregivers. Gaceta Mexicana de Oncología, 17(4), 245-252. Doi: 10.24875/j.gamo.M19000174.

Diniz, M., Melo, B., Neri, K.H., Casemiro, F.G., Figueiredo, L.C., Gaioli, C. y Gratão, A. (2018). Comparative study between formal and informal caregivers of older adults. Ciencia & Saude Coletiva, 23(11), 3789-3798. Doi: 10.1590/1413-812320182311.16932016.

Estrada C., E., Contreras, C.M., Saavedra, M., Luna B., I. y López R., C. (2002). Participation of the lateral septal nuclei (LSN) in the antidepressant-like actions of progesterone in the forced swimming test (FST). Behavioural Brain Research, 134(1-2), 175-183. Doi: 10.1016/s0166-4328(02)00023-2.

Garassini M., E. (2016). Los cuidadores primarios de pacientes con cáncer: aprendizajes y recomendaciones a las familias, sociedades y centros de salud. Psicología y Salud, 26(2), 160-175.

García L., E.P. (2016). Puesta al día: cuidador informal. Enfermería C y L, 8(1), 71-77.

Geng, H.M., Chuang, D.M., Yang, F., Yang, Y., Liu, W.M., Liu, L.H. y Tian, H.M. (2018). Prevalence and determinants of depression in caregivers of cancer patients: a systematic review and meta-analysis. Medicine, 97(39), 11863. Doi: 10.1097/MD.0000000000011863.

Gérain, P. y Zech, E. (2019). Informal caregiver burnout? Development of a theoretical framework to understand the impact of caregiving. Frontiers in Psychology, 10, 1748. Doi: 10.3389/fpsyg.2019.01748.

Golonka, K., Gawlowska, M., Mojsa-Kaja, J. y Marek, T. (2019). Psychophysiological characteristics of burnout syndrome: resting-state EEG analysis. BioMed Research International, 3764354. Doi: 10.1155/2019/3764354.

González R., M.T., Hernández L., R. y De la Rubia, J.M. (2009). Cuestionario de burnout para amas de casa (CUBAC): evaluación de sus propiedades psicométricas y del modelo secuencial de burnout. Universitas Psychologica, 8(2), 533-543.

Gordon, J.L., Rubinow, D.R., Eisenlohr-Moul, T.A., Xia, K., Schmidt, P.J. y Girdler, S.S. (2018). Efficacy of transdermal estradiol and micronized progesterone in the prevention of depressive symptoms in the menopause transition: a randomized clinical trial. JAMA Psychiatry, 75(2), 149-157. Doi: 10.1001/jamapsychiatry.2017.3998.

Grossi, G., Perski, A., Evengård, B., Blomkvist, V. y Orth-Gomér, K. (2003). Physiological correlates of burnout among women. Journal of Psychosomatic Research, 55(4), 309-316. Doi: 10.1016/s0022-3999(02)00633-5.

Gutiérrez G., A.G., Contreras, C.M. y Díaz M., J.L. (2000). Cómo actúa la progesterona sobre el sistema nervioso central. Salud Mental, 23(2), 42-48. Recuperado de http://www.inprf-cd.gob.mx/pdf/sm2302/sm230242.pdf.

Gutiérrez G., A.G., Contreras, C.M., Vásquez H., D.I., Molina, T. y Jacome J., E. (2009). Testosterone reduces cumulative burying in female Wistar rats with minimal participation of estradiol. Pharmacology, Biochemistry & Behavior, 93(4), 406-412. Doi: 10.1016/j.pbb.2009.06.002.

Hall, A., Lynagh, M., Carey, M., Sanson-Fisher, R. y Mansfield, E. (2017). Who are the support persons of haematological cancer survivors and how is their performance perceived? Psycho-Oncology, 26(12), 2201-2207. Doi: 10.1002/pon.4449.

Islas, N., Ramos, B., Aguilar, M. y García, M. (2006). Perfil psicosocial del cuidador primario informal del paciente con EPOC. Revista del Instituto Nacional de Enfermedades Respiratorias, 19(4), 266-271.

Joffe, H., de Wit, A., Coborn, J., Crawford, S., Freeman, M., Wiley, A., Athappilly, G., Kim, S., Sullivan, K.A., Cohen, L.S. y Hall, J.E. (2020). Impact of estradiol variability and progesterone on mood in perimenopausal women with depressive symptoms. The Journal of Clinical Endocrinology and Metabolism, 105(3), 642-650. Doi: 10.1210/clinem/dgz181.

Kent, E.E., Rowland, J.H., Northouse, L., Litzelman, K., Chou, W.Y., Shelburne, N., Timura, C., O’Mara, A. y Huss, K. (2016). Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer, 122(13), 1987-1995. Doi: 10.1002/cncr.29939.

Koutsimani, P., Montgomery, A. y Georganta, K. (2019). The relationship between burnout, depression and anxiety: a systematic review and meta-analysis. Frontiers in Psychology, 10, 284. Doi: 10.3389/fpsyg.2019.00284.

Mariotti, F., Gonçalves, B., Pimpão, G., Mônico-Neto, M., Antunes, H., Viana, M.B., Céspedes, I.C. y Le Sueur-Maluf, L. (2020). A single ovarian stimulation, as performed in assisted reproductive technologies, can modulate the anxiety-like behavior and neuronal activation in stress-related brain areas in rats. Hormones and Behavior, 124, 104805. Doi: 10.1016/j.yhbeh.2020.104805.

Márquez I., F., Díaz, Y., Franco, V. y Oliva, I. (2016). Modos de afrontamiento y resiliencia en cuidadores primarios de pacientes oncogeriátricos. Revista del Hospital Psiquiátrico de La Habana, 13(2), 1-16.

Maslach, C., Jackson, S.E. y Leiter, M.P. (1996). Maslach Burnout Inventory Manual. Sierra Madre, CA: Mountain View.

Montero, X., Jurado, S. y Méndez, J. (2015). Variables que predicen la aparición de sobrecarga en cuidadores primarios informales de niños con cáncer. Psicooncología, 12(1), 67-86.

Mulhall, S., Yel, R. y Anstey, K.J. (2018). Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas, 108, 7-12. Doi: 10.1016/j.maturitas.2017.11.005.

Orcasitas P., L.T. y Uribe R., A.F. (2010). La importancia del apoyo social en el bienestar de los adolescentes. Psychologia: Avances de la Disciplina, 4(2), 69-82. Recuperado de http://www.scielo.org.co/pdf/psych/v4n2/v4n2a07.pdf.

Ortiz M., S., Willey, J.F. y Chiang, J.J. (2014). How stress gets under the skin, o cómo el estrés psicológico se introduce bajo la piel. Revista Médica de Chile, 142(6), 767-774.

Pérez S., I.N., Rascón G., M.L. y Villafaña T., J. (2014). Coping and emotional discomfort in primary caregivers of cancer patients. Revista de Investigación Clínica, 66(6), 495-504. Recuperado de https://www.medigraphic.com/pdfs/revinvcli/nn-2014/nn146d.pdf.

Piette, P. (2020). The pharmacodynamics and safety of progesterone. Best Practice & Research. Clinical Obstetrics & Gynaecology, 69, 13-29. Doi: 10.1016/j.bpobgyn.2020.06.002.

Ravi, M., Stevens, J.S. y Michopoulos, V. (2019). Neuroendocrine pathways underlying risk and resilience to PTSD in women. Frontiers in Neuroendocrinology, 55, 100790. Doi: 10.1016/j.yfrne.2019.100790.

Revenson, T., Griva, K., Luszczynska, A., Morrison, V., Panagopoulou, E., Vilchinsky, N. y Hagedoorn, M. (2016). Caregiving in the illness context. New York: Springer.

Rizo A., C., Molina, M., Milian N., C., Pagán P., E. y Machado, J. (2016). Caracterización del cuidador primario de enfermo oncológico en estado avanzado. Revista Cubana de Medicina General Integral, 32(3), 1-13.

Robles, R., Varela, R., Jurado, S. y Páez, F. (2001). The Mexican version of the Beck Anxiety Inventory: psychometric properties. Revista Mexicana de Psicología, 18(2), 211-218.

Rodríguez G., A.M., Rodríguez M., E., Duarte P., A., Díaz S., E., Barbosa Á., Á., Clavería, A. y Zarit, G. (2017). Estudio observacional transversal de la sobrecarga en cuidadoras informales y los determinantes relacionados con la atención a las personas dependientes. Atención Primaria, 49(3), 156-165.

Rodríguez L., J.F., Contreras, C.M. y García R., R. I. (2009). Allopregnanolone microinjected into the lateral septum or dorsal hippocampus reduces immobility in the forced swim test: participation of the GABAA receptor. Behavioural Pharmacology, 20(7), 614-622. Doi: 10.1097/FBP.0b013e328331b9f2.

Saavedra, M., Contreras, C.M., Azamar A., G. y Hernández L., M. (2006). Differential progesterone effects on defensive burying and forced swimming tests depending upon a gradual decrease or an abrupt suppression schedules. Pharmacology, Biochemistry and Behavior, 83(1), 130-135. Doi: 10.1016/j.pbb.2005.12.016.

Sandoval, F., Tamiya, N., Lloyd-Sherlock, P. y Noguchi, H. (2019). The relationship between perceived social support and depressive symptoms in informal caregivers of community-dwelling older persons in Chile. Psychogeriatrics: The Official Journal of the Japanese Psychogeriatric Society, 19(6), 547-556. Doi: 10.1111/psyg.12438.

Schaufeli, W.B. y Taris, T.W. (2005). The conceptualization and measurement of burnout: Common ground and worlds apart. Work & Stress, 19(3), 256-262. Doi: 10.1080/02678370500385913.

Schüle, C., Nothdurfter, C. y Rupprecht, R. (2014). The role of allopregnanolone in depression and anxiety. Progress in Neurobiology, 113, 79-87. Doi: 10.1016/j.pneurobio.2013.09.003.

Shi, J., Chen, L., Su, Y. y Chen, M. (2019). Offspring caregivers of Chinese women with breast cancer: their social support requests and provision on social media. Telemedicine, Journal and e-Health, 25(8), 748-755. Doi: 10.1089/tmj.2018.0176.

Sisto, A., Vicinanza, F., Campanozzi, L.L., Ricci, G., Tartaglini, D. y Tambone, V. (2019). Towards a transversal definition of psychological resilience: a literature review. Medicine, 55(11), 745. Doi: 10.3390/medicina55110745.

Slavich, G.M. y Sacher, J. (2019). Stress, sex hormones, inflammation y major depressive disorder: extending social signal transduction theory of depression to account for sex differences in mood disorders. Psychopharmacology, 236(10), 3063-3079. Doi: 10.1007/s00213-019-05326-9.

Süss, H. y Ehlert, U. (2020). Psychological resilience during the perimenopause. Maturitas, 131, 48-56. Doi: 10.1016/j.maturitas.2019.10.015.

Süss, H., Willi, J., Grub, J. y Ehlert, U. (2020). Psychosocial factors promoting resilience during the menopausal transition. Archives of Women’s Mental Health. Doi: 10.1007/s00737-020-01055-7.

Tangen, T. y Mykletun, A. (2008). Depression and anxiety through the climacteric period: an epidemiological study (HUNT-II). Journal of Psychosomatic Obstetrics and Gynaecology, 29(2), 125-131. Doi: 10.1080/01674820701733945.

Voultsos, P., Koungali, M., Psaroulis, K. y Boutou, A.K. (2020). Burnout syndrome and its association with anxiety and fear of medical errors among intensive care unit physicians: A cross-sectional study. Anaesthesia and Intensive Care, 48(2), 134-142. Doi: 10.1177/0310057X20902780.

West, C.P., Dyrbye, L.N., Sinsky, C., Trockel, M., Tutty, M., Nedelec, L., Carlasare, L.E. y Shanafelt, T.D. (2020). Resilience and burnout among physicians and the general US working population. JAMA Network Open, 3(7), 209385. Doi: 10.1001/jamanetworkopen.2020.9385.

Zhao, D., Liu, C., Feng, X., Hou, F., Xu, X. y Li, P. (2019). Menopausal symptoms in different substages of perimenopause and their relationships with social support and resilience. Menopause, 26(3), 233-239. Doi: 10.1097/GME.0000000000001208.